Provider Demographics
NPI:1053577361
Name:WESTERHAM, PATRICK PAUL (MSW, LCSW, LICSW)
Entity type:Individual
Prefix:
First Name:PATRICK
Middle Name:PAUL
Last Name:WESTERHAM
Suffix:
Gender:M
Credentials:MSW, LCSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 CARMICHAEL RD STE 206
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:WI
Mailing Address - Zip Code:54016-8271
Mailing Address - Country:US
Mailing Address - Phone:715-318-1174
Mailing Address - Fax:651-314-0350
Practice Address - Street 1:131 CARMICHAEL RD STE 206
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:WI
Practice Address - Zip Code:54016-8271
Practice Address - Country:US
Practice Address - Phone:715-318-1174
Practice Address - Fax:651-314-0350
Is Sole Proprietor?:No
Enumeration Date:2008-08-06
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN141821041C0700X
WI7914-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical